Clinical-Grade Patches as a Medium for Enrichment of Sweat-Extracellular Vesicles and Facilitating Their Metabolic Analysis.

Cell-secreted extracellular vesicles (EVs), carrying components such as RNA, DNA, proteins, and metabolites, serve as candidates for developing non-invasive solutions for monitoring health and disease, owing to their capacity to cross various biological barriers and to become integrated into human sweat. However, the evidence for sweat-associated EVs providing clinically relevant information to use in disease diagnostics has not been reported. Developing cost-effective, easy, and reliable methodologies to investigate EVs' molecular load and composition in the sweat may help to validate their relevance in clinical diagnosis. We used clinical-grade dressing patches, with the aim being to accumulate, purify and characterize sweat EVs from healthy participants exposed to transient heat. The skin patch-based protocol described in this paper enables the enrichment of sweat EVs that express EV markers, such as CD63. A targeted metabolomics study of the sweat EVs identified 24 components. These are associated with amino acids, glutamate, glutathione, fatty acids, TCA, and glycolysis pathways. Furthermore, as a proof-of-concept, when comparing the metabolites' levels in sweat EVs isolated from healthy individuals with those of participants with Type 2 diabetes following heat exposure, our findings revealed that the metabolic patterns of sweat EVs may be linked with metabolic changes. Moreover, the concentration of these metabolites may reflect correlations with blood glucose and BMI. Together our data revealed that sweat EVs can be purified using routinely used clinical patches, setting the foundations for larger-scale clinical cohort work. Furthermore, the metabolites identified in sweat EVs also offer a realistic means to identify relevant disease biomarkers. This study thus provides a proof-of-concept towards a novel methodology that will focus on the use of the sweat EVs and their metabolites as a non-invasive approach, in order to monitor wellbeing and changes in diseases.

Residential Exposure to Dampness Is Related to Reduced Level of Asthma Control among Adults.

We assessed potential relations between indicators of indoor dampness and mold exposures at home and the level of asthma control among adults. The present population-based cross-sectional study, the Northern Finnish Asthma Study (NoFAS), included 1995 adult subjects with bronchial asthma who replied to study questionnaires (response rate: 40.4%). The Asthma Control Test (ACT) was used as the measure of asthma control. We calculated the mean difference in ACT score (ACTdifference) and the risk ratio (RR) of poor asthma control (ACT ≤ 19) for the exposure and reference groups and applied Poisson regression to adjust for potential confounding. Exposure to indoor dampness at home was related to a significantly reduced level of asthma control (ACTdifference: -0.83, 95% CI: -1.60 to -0.07), especially among men (ACTdifference: -2.68, 95% CI: -4.00 to -1.37). Water damage (aRR = 1.29, 95% CI: 1.01, 1.65) and indoor dampness, especially among men (aRR = 1.92, 95% CI: 1.15, 3.20), increased the risk of poor asthma control. We provide evidence that exposure to indoor dampness at home reduces asthma control among adults, especially in men. Indoor visible mold and mold odor were not significantly related to asthma control. Advice on how to prevent indoor dampness at home should be an important part of asthma management.

Subtypes of Asthma and Cold Weather-Related Respiratory Symptoms.

(1) Poor asthma control increases the occurrence of cold weather-related symptoms among adult asthmatics. We assessed whether the subtype of asthma, taking into account the severity of the asthma, plays a role in these symptoms. (2) We conducted a population-based cross-sectional study of 1995 adult asthmatics (response rate 40.4%) living in northern Finland using a questionnaire that asked about cold weather-related respiratory symptoms including (1) shortness of breath, (2) prolonged cough, (3) wheezing, (4) phlegm production, and (5) chest pain, as well as questions related to the subtype of asthma. For women, the subtypes identified using latent class analysis were: (1) Controlled, mild asthma, (2) Partly controlled, moderate asthma, (3) Uncontrolled, unknown severity, and (4) Uncontrolled, severe asthma, and for men: (1) Controlled, mild asthma, (2) Uncontrolled, unknown severity, and (3) Partly controlled, severe asthma. (3) According to the subtypes of asthma, more severe and more poorly controlled asthma were related to the increased prevalence of cold weather-related respiratory symptoms when compared with those with mild, controlled asthma. This trend was especially clear for wheezing and chest pain. For example, in men, the adjusted prevalence ratio of wheezing was 1.55 (95% CI 1.09-2.19) in uncontrolled asthma with unknown severity and 1.84 (95% CI 1.26-2.71) in partly controlled severe asthma compared with controlled, mild asthma. (4) Our study provides evidence for the influence of subtypes of asthma on experiencing cold weather-related respiratory symptoms. Both women and men reported more cold weather-related symptoms when their asthma was more severe and uncontrolled compared with those who had mild and well-controlled asthma.

Association between regular exercise and asthma control among adults: The population-based Northern Finnish Asthma Study.

Previously those with asthma were often advised to avoid strenuous exercise because of fear for exercise-induced asthmatic reactions, but recent findings suggest many beneficial effects on health related to exercise. We elaborated on the relation between regular exercise and asthma control among adults. This was a population-based cross-sectional Northern Finnish Asthma Study (NoFAS), in which altogether 1922 adult subjects 17-73 years old living in Northern Finland answered the NoFAS questionnaire. The determinant of interest was the total amount of regular exercise during leisure time, measured in hours per week and categorized into no, low (>0≤2h per week), medium (>2 ≤5h), high (>5≤10h) and very high (>10h) exercise categories. The outcome of interest was asthma control, which was assessed based on the Asthma Control Test (ACT). As statistical methods we applied analysis of variance (ANOVA) and Poisson regression. ACT score increased gradually, i.e. asthma control improved, with an increasing amount of exercise from no exercise (mean ACT = 19.4; difference from the reference: -1.57, 95% CI -2.12 to -1.01) to high exercise reference category (mean = 21.0), but was slightly lower (mean = 20.3; -0.64, 95% CI -1.27 to -0.02) in the very high exercise category. Such non-linear relation was present both in women and in men. In conclusion, we provide evidence that moderate to high regular exercise improves asthma control among adults with asthma. Advice about regular exercise should be included as an important part of asthma management for adults.

Cold weather increases respiratory symptoms and functional disability especially among patients with asthma and allergic rhinitis.

Cold weather affects the respiratory epithelium and induces bronchial hyperresponsiveness. We hypothesized that individuals with allergic rhinitis or/and asthma experience cold weather-related functional disability (FD) and exacerbation of health problems (EH) more commonly than individuals without these. This was a population-based study of 7330 adults aged 25-74 years. The determinants of interest, including doctor-diagnosed asthma and allergic rhinitis, and the outcomes, including cold weather-related FD and EH, were measured using a self-administered questionnaire. The prevalences of cold-related FD and EH were 20.3% and 10.3%, respectively. In Poisson regression, the risk of FD increased in relation to both allergic rhinitis (adjusted prevalence ratio (PR) 1.19, 95% CI 1.04-1.37 among men; 1.26, 95% CI 1.08-1.46 among women), asthma (1.29, 0.93-1.80; 1.36, 0.92-2.02, respectively) and their combination (1.16, 0.90-1.50; 1.40, 1.12-1.76, respectively). Also the risk of cold weather-related EH was related to both allergic rhinitis (1.53, 1.15,-2.04 among men; 1.78, 1.43-2.21 among women), asthma (4.28, 2.88-6.36; 3.77, 2.67-5.34, respectively) and their combination (4.02, 2.89-5.59; 4.60, 3.69-5.73, respectively). We provide new evidence that subjects with allergic rhinitis or/and asthma are more susceptible to cold weather-related FD and EH than those without pre-existing respiratory diseases.